In this Episode on Pediatric POCUS, a follow up to Episode 18 Point of Care Ultrasound Pearls and Pitfalls, which covered pericardial effusion, pneumothorax, undifferentiated shock, cardiac arrest & DVT, we bring you 4 of North America’s Pediatric Point of Care Ultrasound gurus recorded live from Toronto during the first ever P2 Conference (PEM POCUS) – Pediatric Emergency Medicine Point of Care Ultrasound.

The format will be a bit different for this episode. I’ve asked each our P2 gurus to describe a case that illustrates their favorite point of care ultrasound application, why they think it is useful, how it improves patient care, a step by step description of how to perform the application, the pearls and pitfalls of the application, and bit about what the literature says about the application. Dr. Jason Fischer on ultrasound-guided nerve blocks, Dr. Alyssa Abo on pediatric lung POCUS, Dr. Adam Sivitz on pediatric appendicitis POCUS and Dr. Alex Arroyo on intussesception.

Written Summary and blog post prepared by Dr. Jason Fischer and Dr. Michael Kilian, November 2014

Cite this podcast as: Fischer, J, Abo, A, Sivitz, A, Arroyo, A, Helman, A. Pediatric POCUS. Emergency Medicine Cases. November, 2014. Accessed [date].

Pediatric EM Point of Care Ultrasound Forearm Nerve Block

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Peds POCUS Ch1 Card

Ch 1 – Pediatric POCUS Forearm Nerve Block

Video of ulnar nerve block by Dr. Mike Stone here

Video of median nerve block by Dr. Mike Stone here

Video of lecture on principals of nerve blocks by Dr. Michael Stone here

Pediatric EM Pneumonia Lung Point of Care Ultrasound

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 Ch2 – Pediatric Pneumonia Lung POCUS

Video of POCUS lung scan by Dr. Mike Stone here.

PV card on using POCUS for a focused lung assessment on ALiEM.

Meta-analysis in Pediatrics summarizes the evidence on using ultrasound to diagnose pneumonia. Abstract

Pediatric EM Abodominal POCUS – Appendicitis & Instussesception

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Peds Abdominal POCUS

Ch 3 Pediatric Abdominal POCUS

EM Cases podcast with Anna Jarvis and Stephen Freedman on Pediatric Appendicitis and Abdominal Pain

For a challenging case of POCUS for Appendicitis on the EDE blog here.

A review with video of pediatric POCUS for Appendicitis here.

For an interesting case of Intussusception picked up by POCUS on the EDE blog go here.

A policy statement from the American Academy of Pediatrics supporting the use of POCUS by pediatric ED physicians here.

For more on Paediatric Emergencies download our free interactice eBook EM Cases Digest Vol. 2 Pediatric Emergenciesem cases digest pediatric emergencies

Dr. Helman, Dr. Aroyo, Dr. Abo, Dr. Sivitz & Dr. Fischer have no conflicts of interest to declare.

Key References

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Sivitz, A et al. Evaluation of Acute Appendicitis by Pediatric Emergency Physician Sonography. Annals of Emergency Medicine. 28.5 (2014): 358-364.e4. Full PDF

Elikashvili, Inna, Ee Tein Tay, and James W Tsung. The Effect of Point of care Ultrasonography on Emergency Department Length of Stay and Computed Tomography Utilization in Children With Suspected Appendicitis. Academic Emergency Medicine 21.2 (2014): 163-170. Full PDF

Fox, J Christian et al. Prospective evaluation of emergency physician performed bedside ultrasound to detect acute appendicitis. European journal of emergency medicine 15.2 (2008): 80-85. Full PDF
Riera, Antonio et al. Diagnosis of intussusception by physician novice sonographers in the emergency department. Annals of emergency medicine 60.3 (2012): 264-268. Full PDF

Volpicelli, Giovanni et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive care medicine 38.4 (2012): 577-591. Full PDF

Shah, Vaishali P, Michael G Tunik, and James W Tsung. Prospective evaluation of point-of-care ultrasonography for the diagnosis of pneumonia in children and young adults.JAMA pediatrics 167.2 (2013): 119-125. Full PDF

Frenkel, O., Mansour, K., & Fischer, J. W. (2012). Ultrasound-guided femoral nerve block for pain control in an infant with a femur fracture due to nonaccidental trauma. Pediatric emergency care, 28(2), 183-184. Full PDF